Attitude to the Formation of Community Health Committee in an Oil Bearing Community in South-South Nigeria

BACKGROUND.Community participation in the running of health services has been identified as key to unlocking the potentials of primary health care in achieving health for all members of the community. This and the desire to entrench democratic practices in Nigeria explain why the revised national policy on health recommended the constitution of community health committees (CHC) in all wards and local governments in the country. This study assessed the attitude of health workers; and members of an oil-bearing community towards this recommendation.METHOD.The study was carried out in Ogbogu; a small semi-urban; oil-bearing community in Rivers State; using a pre-intervention/ post-intervention study design. The attitude of members of the community/ and the health workers in the community's health center were assessed before; and six months after the constitution of a CHC; using focus group discussions; key-informant interviews; and field observations as study tools.RESULTS.The health workers knew the importance of the CHC; but refused the offer of assistance in the constitution of the committee; until they got clearance from their superior. But the idea was warmly received by members of the community. However; six months after the formal inauguration of the committee; the committee was only able to hold 2; out of their 6 scheduled meeting; with only 6; out of the 14 members of the committee; attending all the meetings. Most of the issues discussed during the meetings centered on the accountability of the money realized by the health center. Some members of the committee were frustrated by the committee's inability to effect its decisions; while the health workers felt the community members of the committee were unnecessarily interested in financial matters.CONCLUSIONS The attitude to the CHC was poor. Giving the committee the full powers to effectively utilize the human and material resources of the health center in achieving the health aspirations of the community is thereby recommended

An Assessment of the Functionality of a Community Health Committee in an Oil Bearing Community in South-South Nigeria

BACKGROUND.Primary health care has been identified as the most cost-effective way of realizing health for all; and the health-related millennium development goals; while community participation in the running of health services is recognized as the key to unlocking the potentials of primary health care. This study assessed the effectiveness of a community health committee (CHC) in an oil bearing community in Rivers State; south-south Nigeria.METHOD.The study was carried out using a pre- intervention/ post-intervention study design. The CHC was constituted; and its performance assessed after six months; using five qualitative indicators: needs assessment; leadership; resource mobilization; management and organization that were previously established by Rifkin and coworkers. The data for the study were collected through document analysis; personal observations; and interviews.RESULTS.Members of the CHC had an average age of 47.54 +/- 7.5 years; with at least secondary school education; and were mainly either self-employed or civil servants. The CHC was therefore found to be well constituted. The capacity of the committee for resource mobilization was graded as good; because it was able to make contacts for additional resources for the health center. The committee was however rated poor in the areas of needs assessment; leadership; and management. Most members of the committee did not understand their expected role in the committee. The committee was only able to implement 2 out of the 7 interventions identified during the community needs assessment; and was able to hold just 2 out of the 6 scheduled meetings; with only 6 (42.86%); out of the 14 members of the committee attending all the meetings. The poor performance was attributed to the committee's lack of control over the health center and its staff.CONCLUSION.The constitution of a CHC does not guarantee the expected level of community participation. Effective leadership and full community control of health centers and their staff are therefore recommended